Comparison of Parecoxib and Proparacetamol in Endoscopic Nasal Surgery Patients

Abstract

PurposeThe aim of the study was to compare the efficacy of parecoxib for postoperative analgesia after endoscopic turbinate and sinus surgery with the prodrug of acetaminophen, proparacetamol.Materials and MethodsFifty American Society of Anesthesiology (ASA) physical status I-II patients, receiving functional endoscopic sinus surgery (FESS) and endoscopic turbinectomy, were investigated in a prospective, randomized, double-blind manner. After local infiltration with 1% mepivacaine, patients were randomly allocated to receive intravenous (IV) administration of either 40 mg of parecoxib (n = 25) or 2 g of proparacetamol (n = 25) 15 min before discontinuation of total IV anaesthesia with propofol and remifentanil. A blinded observer recorded the incidence and severity of pain at admission to the post anaesthesia care unit (PACU) at 10, 20, and 30 min after PACU admission, and every 1 h thereafter for the first 6 postoperative h.ResultsThe area under the curve of VAS (AUCVAS) calculated during the study period was 669 (28 - 1901) cm·min in the proparacetamol group and 635 (26 - 1413) cm·min in the parecoxib group (p = 0.34). Rescue morphine analgesia was required by 14 patients (56%) in the proparacetamol group and 12 patients (48%) in the parecoxib (p ≥ 0.05), while mean morphine consumption was 5 - 3.5 mg and 5 - 2.0 mg in the proparacetamol groups and parecoxib, respectively (p ≥ 0.05). No differences in the incidence of side effects were recorded between the 2 groups. Patient satisfaction was similarly high in both groups, and all patients were uneventfully discharged 24 h after surgery.ConclusionIn patients undergoing endoscopic nasal surgery, prior infiltration with local anaesthetics, parecoxib administered before discontinuing general anaesthetic, is not superior to proparacetamol in treating early postoperative pain.

Recovery after nasal surgery vs. tonsillectomy: discriminant validation of the Postoperative Quality of Recovery Scale

“…This is an expected finding [9][10][11][12][13][14][15] and adds to the capacity of the PQRS to discriminate between surgical procedures. We also found an effect on ADL and in overall recovery, which would be consistent with the differences between groups in pain and nausea.…”

Preemptive Analgesic Efficacy of Gabapentin and Nimesulide in the Functional Endoscopic Sinus Surgery

“…[13,14] Fonksiyonel sinüs cerrahisinde (FESC) ameliyat sonrası ağrı kontrolü aralıklarla uygulanan nonopioid analjeziklere dayanmaktadır. [15][16][17][18] Çalışma-mızda, non-opoid ilaçlar grubunda yer alan diklofenak sodyumu tercih ettik ve ameliyat sonrası 24 saatlik diklofenak ihtiyacının plasebo grubunda en çok ve gabapentin grubunda en az olduğunu göz-lemledik.…”

Protease-Activated Receptor 2 Antagonist Potentiates Analgesic Effects of Systemic Morphine in a Rat Model of Bone Cancer Pain

“…The activation of PAR-2 up-regulates COX expression, 41,42 which is crucial for PAR-2-medaited hyperalgesia. 9,43 While morphine promotes COX-1 gene expression in a rat microglial cell line in a dosedependent manner, [44][45][46] COX inhibitors can effectively reduce pain and morphine requirements in managing postoperative acute pain. [45][46][47][48][49] We found that treatment with a small dose of PAR-2 antagonist enhanced the antinociceptive effect of morphine.…”